Instrument: Clinical Decision Support (CDS) for Substance Abuse


This instrument, composed of validated initial screening and assessment questions, was developed by a panel of drug addiction, primary care and research experts in substance use disorders (SUD) to provide primary care providers with an actionable clinical decision support tool for the identification, brief intervention or referral for SUD therapy. The expert-panel consensus determined that after the patient is administered and has answered ‘yes’ to a one-item screener and completed the DAST-10, responses to a few additional questions were needed for clinical decision support to address (i) types of drugs used, (ii) frequency of use, (iii) report of injection drug administration and (iv) SUD treatment status. The crafting of this clinical decision support took into consideration available evidence and good clinical practice guidelines to develop algorithm-based clinical interventions, while further considering time constraints in primary care visits, clinic work-flow scenarios and the diverse range of clinic and referral resources among general medical settings. Field-testing and validation of this clinical decision support instrument and its common data elements content will be on-going, with efforts and review in primary care settings, the NIDA Clinical Trials Network and other federal agencies.

The Clinical Decision Support (CDS) instrument was developed by B. Tai, et al, 2012, and validation studies are on-going. The instrument is available for use in the public domain; research was supported by the National Institute of Drug Abuse.

Instrument Usage: 
Clinical Research
Electronic Health Record

Tai B, Lindblad R, Gore-Langton R, Ghitza U, Subramaniam G (2012). A Clinical Decision Support model for screening and management of substance use disorders in electronic health records in general medical settings (Abstract #663). The College on Problems of Drug Dependence (CPDD), 74th Annual Meeting, Palm Springs, CA, June 2012.

Ghitza U, Lindblad R, Gore-Langton R, Sparenborg S, Tai B (2011). Electronic medical records project: Implications of adopting standardized core data elements in health IT systems of drug-abuse treatment providers (Abstract #242). The College on Problems of Drug Dependence (CPDD), 73rd Annual Meeting, Hollywood, FL, June 2011.

Ghitza UE, Gore-Langton RE, Lindblad R, Shide D, Subramaniam G, Tai B (2013). Common data elements for substance use disorders in electronic health records: The NIDA Clinical Trials Network experience. Addiction 108:3-8.

Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R (2010). A single-question screening test for drug use in primary care. Arch Intern Med 170:1155-60.

Skinner HA (1982). The Drug Abuse Screening Test. Addict Behav 7(4):363-371.

Sample Form: 
ModuleModule ID
Single-Question Screening Test for Drug Use 3463119
Drug Abuse Screening Test (DAST-10)3463121
Drug Type and Frequency of Use Questions3463165
Injection Drug Use3463215
SUD Treatment/ Status3463224